Journal of North Khorasan

Abstract Background & Objectives: Asthma as a chronic inflammatory process, for management of moderate to severe asthma, needs to use of inhaled anti inflammatory agent, including inhaled corticosteroids. Long term use of corticosteroids may be associated with subtle or potential side effects, including growth suppression or decreased bone mineral density. The purpose of this study was to compare bone density in asthmatic children, receiving long term ICS (longer than 6 month), with standardized bone mass values for healthy children adjusting for age, ethnicity, gender, height and weight and bone area. Material & Methods: In 30 asthmatic children, 5 to I5 years of age, prescribed long-term Fluticasone propionate 400 microgram/day (longer than 6 month) and normal level of serum calcium, phosphorus, Alkaline phosphatase, scheduled for bone density test by DXA and results were compared with bone mass reference values of healthy children. Results: 18 Patients (60%) had significantly lower Z SCORE compared to standardized bone mass values of healthy group (-1< ZSCORE<-2.5), with no significant difference between girls and boys. In low bone mass children, assessed serum 25 (OH) D by ECL (Electrochemiluminescence), in 17 was normal and 1 child (despite normal calcium, phosphorus and Alkaline phosphatase, and no clinical finding) was lower than normal range. Conclusion: in children with asthma receiving high dose corticosteroids, early detection of BMD in essential. This finding warrant investigation with the ultimate goal to promote bone health by increase number and time of study, for children with asthma receiving long term ICS who at risk for compromised bone mass.